Collaboration between providers has long been a key enabler for transformation and improvement in healthcare. Several recent policy drivers have accelerated and set the context for greater collaboration, including: a focus on greater integration and collaboration between system partners through the Health and Care Act 2022; the NHSE requirement for trusts (both acute and mental health providers) to be part of a collaborative; and the success of mutual aid arrangements during the Covid-19 pandemic. This is set against a backdrop of economic and workforce pressures in the NHS driving greater focus on opportunities to reduce costs and achieve economies of scale. The Health and Care Act 2022 formalised the move to collaborative working, and NHSE has set out guidance on how providers should work together at scale in provider collaboratives (NHS England, 2021).
Providers of mental health, learning disability and autism services have been trailblazers in working together, both formally and informally, to deliver more joined-up care through various collaborative arrangements spanning from place-level to pan-ICS level. The NHS Long Term Plan and NHS Mental Health Implementation Plan for 2019/20 to 2023/24 outlined the ambition to develop and strengthen integrated models of primary and community mental health care (NHS England, 2019b). The plans envisioned a new community-based offer, providing access to therapies and support in the community to enable patients to have greater choice and control over their care and to live well in their communities. This theme has been continued by the Labour government, which took office in July 2024, promising "three shifts": from a treatment-based service to one based on prevention; from analogue to digital; and from hospital to community services.
These policy developments and collaborative approaches in mental health services have positioned the sector uniquely to lead the way in shifting care provision into the community. The benefits of this approach are evidenced in reduced inappropriate out-of-area placements and increased investment in community-based services and support. These benefits are being achieved at scale through mental health, learning disability and autism provider collaboratives. This briefing demonstrates how this approach in turn translates into enhanced patient experience and outcomes.
The work of mental health provider collaboratives has enhanced patient experience and outcomes and, looking more broadly, more individuals are accessing mental health care and treatment than ever before. However, there remains significant unmet needs and there are continuing concerns about the quality and safety of mental health services, with sustained levels of investment and focus required to enable improvement (NHS Providers, 2025). A longer-term review by NHS England of the whole system approach to supporting individuals with serious mental illness is planned and aiming to report by the end of 2026 (NHS England, 2024a). There is also work being undertaken nationally to transform the quality of inpatient care, with six 24/7 open access mental health centre pilots that bring together community, crisis and inpatient care into one team now live, and the Health Services Safety Investigations Body is near to completing its national investigations into mental health inpatient care settings: its final thematic report is expected in May.
